WORCESTER MEDICAL
ETHICS

A Roman Catholic Perspective

A project
to assist medical professionals, patients and families in
understanding Roman Catholic teaching on the quality of life and
other moral issues. This is a work in progress. Please check
periodically for updates.

Introduction

The ultimate aim of researchers must not only be breakthroughs and the prospect of fame, but also conducting noble research in an upright, morally defensible manner. This must be no less true in the burgeoning arena of stem-cell research. According to the White Paper, Alternative Sources of Pluripotent Stem Cells, compiled by the President’s Council on Bioethics, they examined four broad approaches to stem cell derivation. The last of those approaches, somatic cell dedifferentiation “may very well turn out to yield the big-payoff sought: fully pluripotent stem cells, obtainable at will, and altogether without any involvement of embryos—and well-suited for autologous transplantation.”

Distinctions in Kinds of Stem Cells

Stem cells are known as totipotent and pluripotent which are capable of differentiating into special cell types, but also are able to renew themselves through cell division. A cell is totipotent if it is capable of dividing and producing all the cells in an organism, including the extraembryonic tissue associated with a particular organism. Eventually, totipotent cells specialize into pluripotent cells that can develop into many but not all the tissues necessary for fetal development. Then, in a development that entails further specialization, pluripotent cells become multipotent such that they portend the rise of cells with a particular function. Pastor Russell E. Saltzman, a diabetic who is opposed to stem cell research, though he could benefit from it said, “Stem cells are described as the Rosetta Stone for all cell research, including cloning. Quite a claim, and it may be true. It may also be quite terrible.”

Somatic Cell Dedifferentiation,

Reprogramming or Induced Pluripotent State Cells (iPSC)

These terms will become increasingly important in the future debate over stem cell research. The promise that such cellular research holds out has been tempered by the fact that stem cells can only be obtained through the destruction of an incipient human life. Reprogramming, however, takes normal somatic cells (e.g., skin cell) and sends each cell back to the pluripotent state. Pluriopotent cells are equal in versatility with embryonic stem cells and, since, they are genetically matched (or autologous and not heterologous) to the original somatic cell donor any tissue developed from them for replacement therapies would not encounter rejection. Crucially, no human embryo would be destroyed in the process. A real breakthrough came in Japan with the pioneering work of Professor Shinya Yamanaka of Kyoto University who added four genes to somatic cells: Oct4, Sox2, c-Myc, and Klf4. This approach does not entail destroying human embryos nor wasting female ova, which are finite in the typical woman. Even Dr. James Thomson, who was the first research scientist to isolate human embryonic stem cells a decade ago, has touted cellular reprogramming. Then, in 1996, Professor Ian Wilmut who successfully played a supervisory—not a clinical role—in the cloning of a mammal, known to the world as Dolly the sheep, by nuclear transfer, announced that he would forego therapeutic cloning, despite being awarded a license to do so by Great Britain’s Human Fertilisation and Embryology Authority (HFEA). Dr. Wilmut was quoted as saying, “This approach [i.e., reprogramming] represents the future of stem cell research.” Once a somatic cell has been reprogrammed back to an earlier stage, then, growing those cells forward to create new organs, cure diseased brains or maladies like Parkinson’s disease cannot be far behind—a morally benign approach with enormous potential for good!

Conclusion

Western moral philosophy has generally supported the maxim that a good end cannot justify a bad means to that end. However, the opposite maxim began as an accusation against the Jesuits, namely, the end justifies the means. There will always be some tension in the relationship between the end and the means that are used to pursue that aim. The term means always refers to the current, existing situation as it is, whereas the end is how things ought to be. Proponents of embryonic stem cell research minimize the nature of an embryo and, so, they conclude that minute life has no inherent rights to prevent its instrumental use. They also claim that the prospective outcomes are so good that almost any means is justifiable. In fact, adult stem cell research has been more fruitful and the development of cell reprogramming offers a win-win proposition